Management of a Large Radicular Cyst in the Maxillary Anterior Region Using Decompression: A Case Report
Abstract:
Radicular cysts are the most common odontogenic cysts of inflammatory origin and are frequently associated with non-vital teeth. While many resolve with conventional root canal therapy, larger lesions may require surgical intervention. Decompression is a conservative alternative to enucleation that reduces intracystic pressure, promoting gradual shrinkage and bone regeneration.This case report describes the management of a large radicular cyst in the maxillary anterior region of a 29-year-old male with a history of trauma and previously initiated root canal therapy. Clinical and radiographic findings revealed non-vital teeth (#11, #12, #13) and a well-defined periapical radiolucency (~13 mm) with labial cortical plate perforation. Persistent exudation despite multiple intracanal medicaments suggested a true cystic lesion. Decompression was performed using a Foley catheter, maintained with daily irrigation until progressive regression was achieved. Definitive treatment included apexification of tooth #12 with Mineral Trioxide Aggregate (MTA) and thermoplastici zed gutta-percha obturation. Given the extensive coronal loss, tooth #12 was restored using fiber-reinforced composite (Ribbond) for improved strength. At 12-month follow-up, clinical and radiographic evaluation confirmed resolution of the lesion and re-establishment of normal trabecular architecture. This case demonstrates decompression as a simple and effective conservative technique for large radicular cysts, enabling lesion regression and successful healing while avoiding enucleation.
